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Streptokinase in the management of arterial thrombosis in infancy
1Department of Paediatric Cardiology, Royal Liverpool Children's Hospital, U.K.
Insights
Intravenous streptokinase effectively treated arterial thrombosis in children. This study found thrombolysis achieved in all patients with minor bleeding complications, indicating safety and efficacy.
Area of Science:
- Pediatric Cardiology
- Hematology
- Pharmacology
Background:
- Arterial thrombosis in children is a serious condition requiring effective treatment.
- Intravenous thrombolytic therapy is a potential treatment option for pediatric arterial thrombosis.
Purpose of the Study:
- To evaluate the safety and efficacy of intravenous streptokinase for treating arterial thrombosis in pediatric patients.
- To determine the optimal dosage and infusion rates of streptokinase in children.
Main Methods:
- Retrospective analysis of 14 children treated with intravenous streptokinase for arterial thrombosis.
- Dosage and infusion rates were adjusted based on treatment response and fibrinogen levels.
- Outcomes assessed included successful thrombolysis and adverse events, particularly bleeding.
Main Results:
- Thrombolysis was achieved in all 14 children within a mean of 16.7 hours.
- Mean fibrinogen levels decreased significantly from pretreatment levels.
- Minor bleeding at arterial puncture sites occurred in 43% of patients, with no major hemorrhages reported.
Conclusions:
- Intravenous streptokinase is a safe and effective treatment for arterial thrombosis in children.
- The study supports the use of streptokinase in pediatric patients with arterial thrombosis, with careful monitoring for bleeding complications.
Abstract:
Fourteen children with a mean age of 9.7 months (range 0.1-34.0 months) and a mean weight of 5.4 kg (range 2.5-10.0 kg) received intravenous streptokinase following arterial thrombosis. A median loading dose of 1000 U/kg (range 750-4000 U/kg) was given followed by an initial median infusion rate of 1000 U/kg/hr (range 750-1000 U/kg/hr). If thrombolysis did not occur and the fibrinogen level remained within the normal range (1.5-4.5 g/l) the infusion rate was increased to a maximum of 3000 U/kg/hr. Thrombolysis was achieved in all cases a mean of 16.7 hours (range 2-44 hours) after the start of treatment. The mean fibrinogen level at thrombolysis was 1.11 g/l (range 0.28-2.25 g/l) compared with pretreatment levels of 2.12 g/l (range 1.4-3.05 g/l). Minor bleeding from arterial puncture sites occurred in 6 children (43%). Streptokinase is a safe and effective treatment for arterial thrombosis in children.